Endovascular Repair of Abdominal Aortic Aneurysm does not Improve Early Survival versus Open Repair in Patients Younger than 60 Years

AbstractObjectivesMultiple randomised trials have demonstrated lower perioperative mortality after endovascular aneurysm repair (EVAR) compared to open surgical repair for infrarenal abdominal aortic aneurysms (AAAs). However, in these trials the mortality advantage for EVAR is being lost within 2 years of repair and the patients evaluated are relatively older with no study specifically comparing EVAR and open repair for patients younger than 60 years of age.DesignA retrospective analysis of prospectively collected data.Materials and methodsPatients younger than 60 years of age who underwent EVAR and open surgical repair for elective infrarenal AAA were identified from the 2007–09 National Surgical Quality Improvement Program (NSQIP) – a prospective database maintained at 237 centres across the United States. Univariate and multivariate analyses were performed.ResultsOf the 651 patients, 369 (56.7%) underwent EVAR and 282 (43.3%) underwent open repair. Thirty-day mortality for EVAR and open repair were 1.1% and 0.4%, respectively. This was not significantly different on univariate (P = 0.22) as well as multivariate (P = 0.69) analysis after controlling for other co-morbidities. On multivariate analysis, body mass index, history of stroke and bleeding disorder prior to surgery were associated with a higher 30-day mortality after AAA repair (combined open and EVAR).ConclusionsThese contemporary results demonstrate that the 30-day mortality rate after open repair is similar to that after EVAR in patients younger than 60 years with infrarenal AAA

A trapped-ion local field probe

We introduce a measurement scheme that utilizes a single ion as a local field probe. The ion is confined in a segmented Paul trap and shuttled around to reach different probing sites. By the use of a single atom probe, it becomes possible characterizing fields with spatial resolution of a few nm within an extensive region of millimeters. We demonstrate the scheme by accurately investigating the electric fields providing the confinement for the ion. For this we present all theoretical and practical methods necessary to generate these potentials. We find sub-percent agreement between measured and calculated electric field values

Optimum electrode configurations for fast ion separation in microfabricated surface ion traps

For many quantum information implementations with trapped ions, effective shuttling operations are important. Here we discuss the efficient separation and recombination of ions in surface ion trap geometries. The maximum speed of separation and recombination of trapped ions for adiabatic shuttling operations depends on the secular frequencies the trapped ion experiences in the process. Higher secular frequencies during the transportation processes can be achieved by optimising trap geometries. We show how two different arrangements of segmented static potential electrodes in surface ion traps can be optimised for fast ion separation or recombination processes. We also solve the equations of motion for the ion dynamics during the separation process and illustrate important considerations that need to be taken into account to make the process adiabatic

Correlation between Load of HPV 16 DNA in Cervical Cancer and HPV 16 DNA in Lymph Nodes

OBJECTIVE To determine the association between viral load of human papillomavirus 16 (HPV16) DNA in the primary focus of cervical carcinoma and HPV16 DNA in pelvic lymph nodes.METHODS The HPV16 DNA load was measured by fluorescent quantitation polymerase chain reaction (FQ-PCR) in 17 primary foci. HPV16 DNA was detected by polymerase chain reaction (PCR) using HPV16 type-specific primers in 296 pelvic lymph nodes which were from 17 cases of cervical cancer.RESULTS The viral load of HPV16 DNA showed statistically significant differences between tumors with a diameter of<4 cm and ≥ 4 cm (P < 0.05). Seven of 17 cervical cancer cases had HPV16 DNA positive lymph nodes, designated as the positive group, while the remaining 10 without positive lymph nodes was designated the negative group. The average load of HPV16 DNA showed no significant difference between the 2 groups ( P > 0.05). The load of HPV16 in the primary lesion was not associated with that in the lymph nodes. There were 38 HPV16 DNA positive nodes in the total 296 nodes. The rate of positivity of HPV16 DNA in lymph nodes showed statistically significant differences in consideration of maximum tumor diameter, tumor differentiation, histologic type, depth of myometial infiltration and the metastatic status of the nodes, respectively ( P < 0.05).CONCLUSION Viral load of HPV16 in the primary cancer focus correlated with the quantity of tumor cells in the primary focus but not with the existence of HPV DNA positive lymph nodes. Detection of HPV DNA may help to fi nd the early metastases that cannot be evaluated histopathologically, but the prognostic value of HPV positive lymph nodes needs further examination